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目的 分析首次青年缺血性卒中患者出院、发病90d预后不良的相关危险因素。 方法 回顾性纳入18～45岁、发病72 h内的首次缺血性卒中患者，收集患者人口学信息、血管危险因素、实验室检查结果、入院和出院时NIHSS，以出院时和发病90 d mRS≥2分为预后不良，分别比较预后不良组和预后良好组危险因素的差异和病因分型特点，并采用多因素logistic回归分析出院和90 d预后不良的独立危险因素。 结果 研究共纳入691例首次青年缺血性卒中患者，出院预后不良234例（33.9%），90 d预后不良154例（22.3%）。出院时预后的独立危险因素包括入院时高NIHSS（OR 2.76，95%CI 2.07～3.68，P

目的 探讨TG水平对社区高血压患者认知功能的影响。 方法 本研究为基于社区人群的前瞻性队列研究，研究对象为北京市昌平区北七家社区卫生服务中心辖区内40岁以上常住居民中的高血压患者。2015—2016年完成首次人口学、既往病史、实验室检查、认知功能评价（采用MoCA评估）等信息采集。随访7～8年，于2023年随访认知功能，以△MoCA（基线MoCA评分－随访MoCA评分）评估研究对象的认知功能下降情况。采用多因素线性回归探讨TG水平对认知功能下降的影响。 结果 研究共纳入338例患者，平均年龄为（59.1±6.8）岁，男性111例（32.8%）。TG水平与认知功能下降（△MoCA）呈正相关（β=0.172，P=0.025），且主要与视空间执行功能下降相关（β=0.152，P=0.045）。 结论 社区高血压患者TG水平升高与认知功能下降独立相关，且可能主要影响视空间执行功能。 Abstract: Objective To investigate the effects of TG levels on cognitive function in community patients with hypertension. Methods This study was a prospective cohort study based on community population. The subjects were hypertensive over 40 years old in Beiqijia Community Health Service Center, Changping District, Beijing. The first collection of information on demographics, medical history, laboratory tests, and assessment of cognitive function (using the MoCA) was completed from 2015 to 2016. Cognitive function was reassessed in 2023 after a follow-up of 7-8 years. Cognitive decline was defined as ΔMoCA (baseline MoCA score－follow-up MoCA score). Multivariate linear regression was used to analyze the effects of TG levels on cognitive decline. Results A total of 338 patients [mean age (59.1±6.8) years, 111(32.8%) males] were included. TG levels were positively correlated with cognitive decline (ΔMoCA) (β=0.172, P=0.025), and were mainly correlated with the decline of visuospatial executive function (β=0.152, P=0.045). Conclusions There is an independent correlation between the increased TG level and the decreased cognitive function in community patients with hypertension, and it may primarily affect the visuospatial executive function.

摘要： 目的 探讨对神经内科研究生应用高压氧科混合式教学模式的效果。 方法 纳入2023年4—12月在高压氧科实习的神经内科研究生为研究对象。授课前发放调查问卷摸底研究生基础情况和需求后，应用混合式教学模式向研究生讲授高压氧理论知识和实际操作（共40学时），授课后根据出科考试和问卷调查评估教学效果。 结果 研究共纳入15名神经内科研究生，前期调查问卷显示，13名（86.67%）神经内科研究生希望将高压氧作为选修课程。采用混合式模式教学后，15名神经内科研究生均通过出科考试，出科考试成绩为（93.53±3.14）分。神经内科研究生对高压氧定义和作用机制的知晓率从授课前的40.00%（6例）提升至100%（15例）（P=0.0003）；对高压氧治疗适应证和禁忌证的知晓率从授课前的33.33%（5例）提升至93.33%（14例）（P=0.0008）；教学后，研究生对高压氧治疗方案的知晓率为80.00%（12例）。神经内科研究生对教学的满意度为100%（15例）。 结论 混合式教学模式可提升高压氧教学水平，使神经内科研究生有效掌握高压氧学科知识，教学效果显著。 Abstract: Objective To explore the effect of blending learning model in training teaching of hyperbaric oxygen (HBO) for postgraduates majoring in neurology. Methods Postgraduates who major in neurology and work as interns in the Department of HBO from April to December 2023 were enrolled in this study. After sending out questionnaires to investigate the basic situation and needs of postgraduates, the blending learning model was applied to teach theoretical knowledge and practical operations of HBO, and the total credit hours were 40. Exams and questionnaires were used to evaluate the teaching effect. Results A total of 15 neurology postgraduates were included in the study. According to the questionnaire, 13 (86.67%) neurology postgraduates hoped to take HBO as an elective course. After adopting the blending learning model, all 15 neurology postgraduates passed the exam, and the score was (93.53±3.14) points. During the course, the awareness rates of HBO definition and mechanism in these postgraduates increased from 40.00% (6 cases) to 100% (15 cases) (P=0.0003), and the awareness rates of HBO indications and contraindications increased from 33.33% (5 cases) to 93.33% (14 cases) (P=0.0003). Besides, 12 postgraduates (80%) were aware of HBO treatment regimens. The satisfaction rating of these postgraduates was 100% (15 cases). Conclusions Blending learning model can effectively enhance the teaching level of HBO, and enable the postgraduates who major in neurology to master the knowledge of HBO more effectively.

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The circulation of data factor is the key to the development of the digital economy, and security first is the principle of building data factor market. This paper focuses on the civil aviation field, and describes the current data resource characteristics and circulation status, as well as the security challenges faced by multi-subject participation. A three-layer model is proposed, which is based on intra-enterprise data governance, intra-industry data circulation and crossindustry data circulation. Taking the data governance practice of Travelsky Technology Limited as an example, this paper introduces data architecture governance, data standard implementation, classification and full life cycle security protection. Finally, data factor circulation and security governance in civil aviation field are prospected. [ABSTRACT FROM AUTHOR]

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自发性脑出血是卒中的一种严重亚型，在中国卒中患者中占23.4%，以急性发病、病情迅速变化以及高致死和致残率为显著特点。鉴于管理脑出血所面临的紧迫和复杂挑战，本指南旨在为其临床处理提供系统性和全面性的推荐意见。本章节覆盖了从脑出血院前评估、医疗干预到二级预防和康复的各个关键环节。在具体推荐方面，本指南根据不同的证据等级，为早期诊断、影像学评估、急性期干预、内科和重症监护、外科干预以及二级预防策略提供了指导，旨在全面提升自发性脑出血诊疗的科学性和系统管理质量。 Abstract: Spontaneous intracerebral hemorrhage represents a severe subtype of stroke, accounting for approximately 23.4% of stroke cases in China. It is characterized by its rapid onset, swift disease progression, and high rates of mortality and disability. Given the urgency and complexity in managing intracerebral hemorrhage, this guideline aims to provide systematic and comprehensive recommendations for its clinical management. This chapter covers all key aspects ranging from pre-hospital evaluation and medical intervention to secondary prevention and rehabilitation. With respect to specific recommendations, this guideline offers exhaustive guidance based on varying levels of evidence for early diagnosis, imaging assessments, acute-phase interventions, medical and ICU management, surgical interventions, and secondary prevention strategies, with the ultimate aim of enhancing the scientific rigor and systematic quality of spontaneous intracerebral hemorrhage management.

Objective To compare the differences in clinical outcomes of different treatments for anterior circulation tandem lesions. Methods Databases including PubMed, Cochrane Library, ScienceDirect, CNKI, VIP, and Wanfang were retrieved from inception to December 11, 2021 to search for the literatures involving interventional treatment for anterior circulation tandem lesions in patients with acute ischemic stroke. The patients were divided into the intervention group and control group. Treatment strategy in intervention group was simultaneous emergency interventional treatment of both lesions, including thrombectomy or thrombolysis combined with stenting, and treatment strategy in control group was first interventional treatment of the responsible lesion, including thrombectomy or thrombolysis combined with stenting, and then selective treatment of the other lesion. The clinical outcomes including technical recanalization (TICI≥2b) rate, 90-day good prognosis (mRS score of 0-2), and mortality rate were compared between the two groups. The literature quality was evaluated according to Cochrane systematic evaluation principles, and then meta-analysis was performed using R version 4.1.2. When ≥5 studies were included, funnel plots were drawn toidentify publication bias and asymmetry test were performed. Results A total of 6 literatures were included in the final analysis, involving 779 patients with 584 in intervention group and 195 in control group. Meta-analysis results showed that there were statistical differences in technical success rate (OR 2.14, 95%CI 1.68-2.74, P =0.002), 90-day good prognosis rate (OR 1.46, 95%CI 1.20-1.76, P =0.049), and mortality rate (OR 0.60, 95%CI 0.47-0.76, P =0.035) between the intervention and control groups. The funnel plot was symmetrical from left to right, indicating that there was no significant publication bias for the included literatures. Conclusions In patients with anterior circulation tandem lesions, simultaneous emergency interventional treatment of both lesions is prone to higher recanalization rate, better 90-day clinical prognosis and lower mortality rate. 目的 比较脑动脉前循环串联病变所致急性缺血性卒中不同治疗方法的临床预后差异。方法 计算机检索PubMed、Cochrane Library、ScienceDirect、CNKI、VIP、万方数据库从建库至2021年12月11日公开发表的关于脑动脉前循环串联病变的急性缺血性卒中患者介入治疗方式的文献。结局指标采用术后血流再灌注TICI评分≥2b级、90 d预后良好（mRS 0～2分）和死亡率对干预组（两个病灶同时急诊介入治疗，包括取栓/溶栓治疗联合支架治疗）和对照组（先对判定的责任病灶进行介入治疗，包括取栓/溶栓联合支架治疗，另一病灶择期处理）进行评估。根据Cochrane系统评价原则对纳入的研究进行质量评价后采用R version 4.1.2进行多重测量结局的meta分析，效应指标以OR 及95%CI表示。纳入研究≥5项，绘制漏斗图识别发表偏倚及进行不对称检验。结果 最终纳入6篇符合标准的文献，共779例患者，其中干预组584例，对照组195例。多重测量结局的meta分析结果显示，干预组与对照组TICI≥2b级（OR 2.14，95%CI 1.68～2.741，P =0.002）、90 d良好预后率（OR 1.46，95%CI 1.20～1.76，P =0.049）、死亡率（OR 0.60，95%CI 0.47～0.761，P =0.035）的差异均有统计学意义。漏斗图左右对称，表明本研究纳入的文献发表偏倚不明显。结论 在脑动脉前循环串联病变患者中，两个病灶同时进行急诊介入治疗血流再灌注更好，90 d临床预后更优，死亡率更低。脑动脉前循环病变的介入治疗是临床急性缺血性卒中再灌注治疗的难点和争议点，本研究通过meta分析对目前发表的相关文章进行了综合，结果显示对串联病变同时进行急诊介入治疗的再灌注效果和90 d预后要优于急诊仅处理单个病变。

【摘要】 目的 利用颈动脉高分辨率磁共振成像（high resolution MRI，HR-MRI）技术分析急性脑梗死患者颈内动脉角（internal carotid artery angle，ICAA）与动脉粥样硬化斑块形态学特点，探讨ICAA与动脉粥样硬化斑块形态的关系。 方法 入组2011年11月-2012年6月的急性颈内动脉系统脑梗死患者，行颈动脉HR-MRI检查，获得每例患者左右侧ICAA及动脉粥样硬化斑块形态资料。根据ICAA大小的中位数将颈动脉分为ICAA≥35°组和ICAA＜35°组，比较两组血管颈动脉粥样硬化斑块发生率和斑块特点。分别以左右侧颈动脉粥样硬化各斑块成分总量为因变量，对其可能的影响因素进行多因素回归分析。 结果 共有86例患者的162支颈动脉图像纳入最终分析，其中ICAA≥35°组78支，ICAA＜35°组84支，ICAA≥35°组动脉粥样硬化斑块检出率[72支（92.3%）vs 47支（56.0%），P＜0.01]及易损斑块检出率[34支（43.6%）vs 13支（15.5%），P=0.03）]均较ICAA＜35°组高，差异有统计学意义。ICAA≥35°组动脉粥样硬化斑块中富含脂质坏死核心[59支（75.6%）vs 31支（36.9%），P

目的 研究血浆和肽素水平对脑出血患者临床结局的预测价值。 方法 连续入组2011年1月-2012年5月期间住院的自发性脑出血患者，并收集患者的性别、年龄、既往史及血压、实验室检查、影像学检查信息等。入院时进行GCS评分及NIHSS评分，检测血浆和肽素水平。随访患者30 d生存情况及90 d功能预后（mRS评分）。应用Logistic回归分析上述因素对急性脑出血患者30 d死亡及90 d预后不良（mRS评分≤3分）的预测价值。 结果 共有133例患者纳入研究。9例（6.8%）患者在脑出血后30 d内死亡。在90 d随访期内，55例（41.4%）患者功能预后不良。基线期血肿体积（OR 1.06，95%CI 1.00～1.13，P=0.047）及NIHSS评分（OR 1.21，95%CI 1.05～1.39，P=0.01）是脑出血90 d预后不良的独立预测因素，基线GCS评分（OR1.41，95%CI 1.21～1.63，P=0.03）及血浆和肽素水平（OR 2.50，95%CI 1.16～5.37，P=0.02）是脑出血患者30 d内死亡的独立预测因素。 结论 血浆和肽素水平高是脑出血短期死亡的独立预测因素。 Objective To investigate the predictive value of plasma copeptin in patients with intracranial hemorrhage. Methods Patients with spontaneous cerebral hemorrhage who were hospitalized in Beijing Tian Tan Hospital from January 2011 to May 2012 were consecutively enrolled. Clinical data of patients, such as gender, age, previous history, blood pressure, laboratory test results, imaging information, as well as GCS and NIHSS scores and plama Copeptin levels were collected at admission. The outcome at 30-day and 90-day was assessed by mRS. Logistic regression analysis was used to evaluate the predictive value of plasma copeptin for 30-day mortality and unfavorable prognosis at 90-day. Results A total of 133 patients were included in the study. 9 patients (6.8%) died within 30 days of cerebral hemorrhage. 55 patients (41.4%) had unfavorable functional prognosis at 90-day followup. Baseline hematoma volume (OR 1.06, 95%CI 1.00-1.13, P=0.047) and NIHSS score (OR 1.21, 95%CI 1.05-1.39, P=0.01) were independent predictors of poor prognosis at 90 days after intracerebral hemorrhage. GCS score (OR 1.41, 95%CI 1.21-1.63, P=0.03) and plasma Copeptin level (OR 2.50, 95%CI 1.16-5.37, P=0.02) were independent predictors of 30-day mortality after intracerebral hemorrhage. Conclusions Increased plasma copeptin level is an independent predictive factor of 30-day mortality in patients with spontaneous cerebral hemorrhage.

目的 通过对大型社区体检人群的筛查，调查理想心血管健康指标对颈动脉内中膜异常增厚的影 响，为颈动脉疾病及心脑血管病的预防提供证据。 方法 选择参与2015年度国家脑卒中高危人群筛查和干预项目的北京北七家社区服务中心筛查点 40岁以上无卒中病史人群，收集受试者身高、体重、吸烟史等一般临床资料及基线血压、血糖、血脂 水平，同时计算受试者理想心血管健康指标符合数目。所有受试者完善颈部血管超声，记录受试者 颈动脉内中膜厚度，将患者分为颈动脉内中膜异常增厚组和正常组，通过Logistic回归分析两组之间一 般临床资料及理想心血管健康指标对颈动脉内中膜增厚的影响。 结果 共入组4387例受试者，颈动脉内中膜增厚组654例，正常组3733例。与正常组相比，颈动脉 内中膜异常增厚组年龄较高[62（56，69）岁 vs 58（52，64）岁，P